Community Chat

[rac71]

Naes could you explain why the ventilator creates a high risk of pneumonia? My mom failed the breathing test this morning. She couldn't stay awake enough. They ended fentanyl and put her back on propanol(?) which is shorter-lasting in the system.

[dooBdoo]

rac71, You mentioned that you lost a long post. It's a hazard on these forums. The best thing to do is first type your response somewhere else (a notepad area on your computer, in your email account as if you're composing a new message, etc.) and then copy and paste it here when you've completed it. Or, if you write it here, be sure to copy it first before clicking "submit." That will save lots of frustration, and you certainly don't need any additional annoyances right not.

My heart goes out to you. I have no specific advice, but you and your mom, and her health care team, are in my thoughts and prayers. I pray for your father and brother, too, in hopes they can open their eyes and their hearts.

Remember to take good care of yourself, too. Your health and well-being are important.

_Naes, As always, you're a sweetheart.

(((Cyber hugs))) to both of you.

[rac71]

Mama is off the ventilator. She tried to yank th tubes out of her now and off her finger. I got her to stop. Nurse and I rminded her where she was. She promised not to try to pull again and said, "I'm sorry." She was convinced she had to sneeze and her nose was running. Both sensations caused by her oxygen line and the gastric tube. I gave her tissues and she tried several times to reach to wipe her nose. When she kept failing she cussed. How could I help but laugh? I helped wash and comb her hair tonight. When the nurse asked about her headcovering, mom said, "Jewish." Her voice is a whisper but it's there.

[NAES1]

Yes, rac.........really I do understand. If you can, try to tell yourself -what is going to happen here with all of the others' very elementary behavior. Put that to the side. It's not that important, but mom is. The change in medications I am explaining in different posts becaude I have had several messages -never to be seen.

Wonderful news 'mom is off of the ventilator'. Most patients having been IV'd with blood pressure meds do have violent gesters. I am reading the above earlier question which I will explain- post time permitting.

Fentanyl is a poweful analgestic (opiate) which is synthetic..similar to morphine for pain. But now we know she is off of this, now. Heart patients.

There IS a Propofol and then there is (A Propanol)= beta blocker/is safer-when there is a breathing problem, especially for previous MYOCARDIAL INFARCTIION {heart attack-muscle is involved}. This is mainly used for treating high blood pressure OR ANXIETY which she possibly does have. The PROPANOL lowers portal vein pressure "IN" portal high blood pressure.

The FENTANYL was possibly removed as a treatment due to ( a possible complication of cirrhosis related to the portal high blood pressure which could increase the (FULL ABDOMEN hemorrhages). This is all circulatory, that would move probable than possinly compromise the reduction of renal problems. I will be back, soon. Do dismiss anything mom may say. She is very frustrated. Her nurse is trying to focus on her patient, trying to note any behavior changes as different medications are introduce. You are doing a great job!. _Naes

[NAES1]

....than POSSIBLY^^^above. I was tryin to type within the time format.

[NAES1]

mechanical ventilator makes it easier for mom to breathe UNTIL mom is /was to breathe completely on her own. Later on they possibly will do some deep breathing exercises, but that come later.

Infections: The endotracheal tube in the windpipe makes it easier for bacteria to get into the lungs, thus -pneumonia "not" occuring. As a result, the lungs DO develop an infection. The risk is about- mmh,,,,,,,1% for each day spent on the ventilator. That is why I said WONDERFUL, mom is off of the vent.

The doctors do not want any chance of (bacteria)/pneumonia/ becoming severe or difficult to treat, if need of antibiotics-due to what we know of as resistant bacteria.

I hope I answered your question about this.?

Mom's low level oxygen in the blood, even while getting oxygen therapy and/or when the level of carbon dioxide in the bloodstream is sounding better, from what you have told me.

THIS CAN BE TRUE WHEN BREATHING IS BECOMING VERY UNCOMFORTABLE. That's probably when she took out the tube(s)/finger out herself.

3 things to remember: To deliver oxygen. -To eliminate dioxide. To ease the work of breathing.

[NAES1]

On 1/19/2015 rac71 said: Naes could you explain why the ventilator creates a high risk of pneumonia? My mom failed the breathing test this morning. She couldn't stay awake enough. They ended fentanyl and put her back on propanol(?) which is shorter-lasting in the system.

...backk to earlier post, ref: PROPANOL. Yes, short term acting. This is for hypertension, ANXIETY and any pain from herat or ENDOTRACAHEAL tube, a long with blood pressure with 'dys'rhythmias tremors/ "A" beta blocker for (arrhythmia)....to slow down the heart beat.

Now (Diprivan) "PROPOFOL"/ is not to be confused with what mom is on but IS a short term acting (IV) hypnotic used for short period alotted time surgical procedures; I do not know if she had this when the vent was put in. You may have heard of both of these medicatins when mom was rushed to the emergency?

There is an "ACE inhibitor. Those are treat patients with Myocardial Infarction (heart attacks)- Angina pectoris- high blood pressure. Those WIDEN the blood vessels to improve the blood the heart pumps. You may hear a doctor mention this at some time.

Next is the Calcium channel blockers, also for high blood pressure/hypertension- MORE so for Atrial fibrillation, coronary artery disease. Next are the Alpha blockers: there has always been a question about ALPHA blockers Vs Beta blockers. They too, expand vessels so blood passes smoothly. You may hear this brought up. Lastly. on the PROPANOL: THESE RECEPTORS AFFECT heart rate, heart muscle CONTRACTION and the voulume of boold the hear pumps a minute without a problem-this will effectively lower b/p/ Mainly, 'those' are usually for treatment -to relax Smooth muscle tissue found in the prostate & bladder neck.

Hopefully, when you get a chance, you can ask for some cardio packages that explain [each] just to have and study in the event any doctor mentions one or the other.

I do hope that you are resting. I feel that everyone on this story is very proud of what you have accomphished, less the intrusion of your own frustration(s) from family. If my husband can operate a washing machine w/o a manual, then I should think that another member can push a button and put in some detergent. Keep us posted, please.

And I hope that agitator is roaring at top speed, hopefully someone has gotten the hang of washng clothes.

A Beta Blocker treats high blood pressure, irregular heartbeat and a host of other conditions which I do not think that mom has- as in glaucoma, angina, hyperthyroidism et cetra and on.

_Naes

[rac71]

I understand beta blockers. My folks and I are all on them. Me, originally for the accelerated heart rate when I was thyrotoxic and post-I131, now a MUCH lower dose for profession-triggered hypertension. My dad takes it for hypertension, and my mom takes 25 mg 2x a day as part of migraine prevention. Her normal blood pressure is very low, and her heart rate is usually about 70. Back when I was on 150-175 mg 3x a day the diuretic impact was quite powerful. All of this means I have heart disease as an inevitability, now that both parents inherited from theirs. My mom's father had two heart attacks by his early 40s, before she was born. Then nothing for years. They also eventually relocated from Chicago to Arizona so the winters would be less taxing on his heart. I took the cussing as a good sign. It was such a HER moment to say, "Oh, sh--" in frustration. She's also very confused right now and was asking for her pills. I am exhausted. My father needs constant overnight attention whch is rough. 2:30 in the morning he was fussing over needing a good pencil to bring so she can do crossword puzzles. She doesn't have full vision back yet. All she could see yesterday was light, dark and blurry. He's deluding himself into thinking she'll be home in a few days and back to full vigor. I'm hoping her sight comes back; I don't really understand why it isn't there and no medical professional has explained. Maybe it was Propofol? Although I think it is propanol, in the Atenolol family. She's less puffy; the lasiks have been working,

[NAES1]

I had to be where you are, now, as you told me-'I am exhausted'. I have been there only one time with a beloved family member, so I know the running on empty when anyone is the self-appointed caregiver, at home or at hospital when anything like this condition happens.

As dooBdoo said, 'YOU' have to take good care of yourself; your health & well being is just `that` important. I would like for you to know that dooBdoo has gone through a tragic event almost 2 years ago this summer, losing her husband to a heart attack. So she know from first hand experience how the loved one goes through different phases, probably much better than me. She is a dear friend to so many posters and can share her personal journey, in helping while understanding the emotions, fears and how to adapt to abrupt situations.

Ref: eyesight. If mom's eye vision condtion continues, then you can request for an opthalmogist as a referral-now or post hospital. That would be your decision to ask if the hospital would be a large medical center/LG. hospital.

I do not believe that your mother will be leaving the hospital very soon.Actually, there is not a lot of information on the effects of Propranlol associated with blood pressure eye conditions. Each person would be entirely different. Since mom has been through an abrupt shock to her body anything can be expected. Also, Propranolol interaction with other medications that mom (may) be taking definitely could not be compatiable/or she could be having a short time allergic reaction. Honestly, the doctors possibly are clueless as much as the other staff members.

I am assume mom will have a standing appointment before she leaves the hospital/ private care or referral for the eye doctor. 1 week usually.

*There is always,_____ a possibility to an anesthesia____=change in vision as blurry, one eye not as stronger than the other. The cirulation of the vessels throughout the eyes could have been affected.(??) Reason for app't. /eye doctor M.D.

Is it your total functions of the household to do all of the ( I suppose everything)? If so, then you will have to talk with head nurse at this hospital for Medicare/ or private insurance to have a home nurse to come visit, or her {nurse's} best plan whom to call for assistance. Sounds as though you have your hand full with the care of your father before mom's heart attack. There is assistance out there. Someone may be able to direct you better than I could, since I have very little knowledge in that field. "When the patient goes home".

Mom can not go home if she is still confused! ~ I hope that you are better well rested and the tension has subsided to a greater degree. That would be my prayer for you...also,for MAMA~

Smiles for you~ We are concerned and continue to pray for God to be with you and your dear sweet mom_Naes.

[rac71]

Thanks, _Naes. My father's "care" is more about being self-involved and lazy. He does have difficulty with the stairs, so I said I would listen for the dryer in the basement while he was on the top floor. Tonight he offered to, and successfully emptied the entire dishwasher by himself. He asked a couple of questions about unusually-shaped dishes, but did it all by himself. My mom slept all day but was more awake and communicative with me tonight. She said she could see me. She also wanted to tell me my cousin Erwin helped develop the modern way Heparin is made when the nurse said she was giving her some. (In his late 80s, he's also the foremost expert.) her voice alternated between whispers and croaks, but I understood most of it. "I want a Coca-Cola," made me smile and prompted me to promise one as soon as she is cleared to drink gassy liquids. She failed her first swallow test today. I've been through this before with my uncle, so I know how it will be handled with a speech pathologist should she continue to fail. I also appreciate the craving for a good coke. I gave them up last month with my Type 2 diagnosis but have dipped back in for occasional migraines and, yes, her hospitalization. My dad is finally accepting that she won't come home any time soon. Sometime tomorrow (Wednesday) she will transfer out of ICU when a bed becomes available. This is all huge. My parents have long-term care insurance and I suspect someone with the medical staff will recommend rehabilitative facility to help my mom transition. Right now I think having the mother-daughter visits in the evening for 90+ minutes is good for both of us. Please forgive any ramblings.